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Note: “Exchanges” are health insurance marketplaces – organizations set up to facilitate the purchase of health insurance in every state of the United States in accordance with Obamacare. Exchanges provide a set of government-regulated and standardized health care plans from which individuals may purchase health insurance eligible for federal subsidies. All exchanges must be fully certified and operational by January 1, 2014, under federal law. Enrollment in the marketplaces started on October 1, 2013 and will continue for six months.
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If you are among those Americans who’ve signed up on state exchanges, you may be in for a nasty surprise: Many of the top hospitals in the U.S. are opting out of Obamacare altogether, thereby showing that the POS’s promise – that insurance companies will be competing for your dollars under Obamacare — is yet another of his wholly invented fantasies lies.
Tori Richards reports for Watchdog.org (via US News & World Report), Oct. 30, 2013, that Americans who sign up for Obamacare will be getting a big surprise if they expect to access premium health care that may have been previously covered under their personal policies. Most of the top hospitals will accept insurance from just one or two companies operating under Obamacare.
While Obamacare regulations have indeed made insurance more affordable by putting caps on insurance premiums, many insurers are coping with the reduced premiums by offering top-tier doctors and hospitals far less cash for services rendered. And so, many of America’s top hospitals are simply opting out of Obamacare.
UnitedHealth’s board of directors’ Wilsensky explains: “Many companies have selectively entered the exchanges because they are concerned that (the exchanges) will be dominated by risky, high-using populations who wanted insurance (before Obamacare) and couldn’t afford it. They are pressed to narrow their networks to stay within the premiums.”
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies. Other than that, the hospital with the largest number of insurance companies is University Hospitals Case Medical Center in Cleveland with just four. Fully 11 of the 18 hospitals had just one or two carriers.
Insurers operating in the exchanges are apparently hesitant to talk about the trade-off between price and quality. Two of the nation’s largest insurers – Wellpoint and Aetna – refused to respond to a dozen calls and emails from WatchDog.org over the course of a week.
Watchdog.org says if you have a better chance of getting a top quality hospital if you purchase your medical insurance on your own, outside Obamacare. For example, fourth-ranked Cleveland Clinic accepts dozens of insurance plans if you buy one on your own. But go through Obamacare and you have just one choice: Medical Mutual of Ohio.
To makes matters worse, many state exchanges don’t even list the insurance companies on their web sites. Some that do, like California, don’t provide names of doctors or hospitals although the price differences among hospitals “can be pretty profound,” said Joe Mondy, spokesman for Cigna insurance. “When you are doing a cost comparison with doctors, you should look up the quality of the hospital as well. Hospital ‘Y’ could be great at pediatrics and not great at surgery.”
Josh Archambault, senior fellow with the think tank Foundation for Government Accountability who has extensively studied the Affordable Care Act Obamacare, said: “In many cases, consumers are shopping blind when it comes to what doctors and hospitals are included in their Obamacare exchange plans. These patients will be in for a rude awakening once they need care, and get stuck with a big bill for going out-of-network without realizing it.” All of this represents a larger problem with Obamacare. “It reflects deeper issues in implementation. Some hospitals and doctors don’t even know if they are in the network.”
Watchdog.org looked at the top 18 hospitals nationwide as ranked by U.S. News and World Report for 2013-2014, and contacted each hospital to determine if it takes health insurance under Obamacare. Here’s what Watchdog.org found (click image to enlarge):
H/t my friend Sol
~Eowyn